Primary Health Care chief executive Peter Gregg said the Turnbull government's shock bulk-billing funding cuts are "a slap in the face" for medical professionals and warned that Australia is taking its first steps toward a two-tiered system of care.

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Mr Gregg, who oversees 71 medical centres, 100 pathology labs, and 168 diagnostic imaging sites, said on Wednesday that he is piloting selective out-of-pocket charges for some tests and scans to recoup the fee cut.

"The government has done what it has done without any consultation with the industry despite promises they would consult. They either don't understand or they are deliberately misleading the Australian people...we will have to introduce co-pays and out-of-pockets," he said.

"The Minister [Sussan Ley] keeps coming out and saying 'we have no obligation to make the healthcare sector profitable'. Well we have no obligation to make government policy work."

Without mitigating action, Primary estimates its earnings before interest and tax will be hit by around $50 million in 2016-17.

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Mr Gregg said that the government needs to be more transparent about the objectives of its widespread healthcare reform process, and warned the nation could eventually be divided into those who could afford care and those who could not.